Acharya D U, Heber M E, Doré C J, Raftery E B
Department of Cardiology, Northwick Park Hospital, Harrow, England.
Am J Hypertens. 1996 Oct;9(10 Pt 1):943-52. doi: 10.1016/0895-7061(96)00177-X.
Twenty-four-hour recordings of intraarterial blood pressure (IABP) from 723 untreated hypertensive patients were analyzed for the effects of age, sex, race, and body mass index on the level of IABP and its circadian variation. Age had a highly significant positive relationship (P < .001) with the cuff systolic and diastolic blood pressures, with regression coefficients (SE) of +0.83 (0.07) and -0.24 (0.04) mm Hg/year, respectively. There was a similar (P < .001) positive relationship between age and 24-h mean systolic IABP, measuring +0.71 (0.07) mm Hg/year, but 24-h mean diastolic IABP did not increase significantly with age. There was a significant (P < .001) inverse relationship between age and 24-h mean heart rate (HR), at -0.17 (0.03) beats/min/year. Nocturnal fall in systolic and diastolic IABP, calculated as the difference between daytime and nighttime mean IABP, had a significant (P < .001) negative relationship with age. Nocturnal fall in HR, calculated similarly, also significantly (P < .001) decreased with age. Age did not affect long-term systolic and diastolic IABP variability but did decrease long-term HR variability significantly (P < .001). Hypertensive men and women of similar age, had comparable daytime mean systolic and diastolic IABP (P = .15 and P = .03 respectively), but women had significantly (P < .001) lower nighttime mean systolic and diastolic IABP than men. The nocturnal fall in systolic and diastolic IABP was significantly (P < .002) greater in women as compared to men. Women also had significantly (P < .01) greater long-term systolic and diastolic IABP variability than men. Women had significantly (P < .001) greater 24-h, daytime mean and nighttime mean HR than men. Twenty-four-hour, daytime and nighttime mean IABP were all significantly higher (P < .01) in Afro-Caribbeans as compared to whites and Asians. No significant differences were observed in the magnitude of nocturnal IABP fall or long-term IABP variability between the three races. Asians and Afro-Caribbeans had significantly (P < .001) lower nocturnal HR falls and long-term HR variability (P < .01) than whites. Body mass index (BMI) did not relate directly to the level of daytime blood pressure, clinic cuff, or daytime mean IABP, in either men or women. BMI did have a highly significant (P < .001) positive relationship with nighttime mean IABP in men, but not in women. The degree of nocturnal fall of IABP had a significant (P < .001) inverse relationship with BMI in hypertensive men.
对723名未经治疗的高血压患者的动脉内血压（IABP）进行24小时记录，分析年龄、性别、种族和体重指数对IABP水平及其昼夜变化的影响。年龄与袖带收缩压和舒张压呈高度显著的正相关（P <.001），回归系数（SE）分别为+0.83（0.07）和 -0.24（0.04）mmHg/年。年龄与24小时平均收缩期IABP之间存在类似的（P <.001）正相关，为+0.71（0.07）mmHg/年，但24小时平均舒张压IABP并未随年龄显著增加。年龄与24小时平均心率（HR）呈显著的（P <.001）负相关，为-0.17（0.03）次/分钟/年。收缩压和舒张压IABP的夜间下降幅度（计算为白天和夜间平均IABP之差）与年龄呈显著的（P <.001）负相关。以类似方式计算的HR夜间下降幅度也随年龄显著（P <.001）降低。年龄不影响长期收缩压和舒张压IABP变异性，但确实显著降低长期HR变异性（P <.001）。年龄相仿的高血压男性和女性，白天平均收缩压和舒张压IABP相当（分别为P =.15和P =.03），但女性夜间平均收缩压和舒张压IABP显著低于男性（P <.001）。女性收缩压和舒张压IABP的夜间下降幅度显著大于男性（P <.002）。女性长期收缩压和舒张压IABP变异性也显著大于男性（P <.01）。女性24小时、白天平均和夜间平均HR显著高于男性（P <.001）。与白人和亚洲人相比，非裔加勒比人的24小时、白天和夜间平均IABP均显著更高（P <.01）。三个种族之间夜间IABP下降幅度或长期IABP变异性未观察到显著差异。亚洲人和非裔加勒比人的HR夜间下降幅度和长期HR变异性显著低于白人（P <.001和P <.01）。体重指数（BMI）与男性或女性的白天血压水平、诊所袖带血压或白天平均IABP均无直接关系。BMI与男性夜间平均IABP呈高度显著的（P <.001）正相关，但与女性无关。高血压男性中，IABP夜间下降程度与BMI呈显著的（P <.001）负相关。
